This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on ISI (6)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Infectious Diseases, Other  • World Health  • Violence and Human Rights  • War  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Marta Valenciano, DVM, MPH; Denis Coulombier, MD; Barbara Lopes Cardozo, MD, MPH; Alessandro Colombo, MD, MSc; Mouhsen Jar Alla, MD, MPH; Samuel Samson, MD, DPM; Máire A. Connolly, BCh, MPH

JAMA. 2003;290:654-658.

ABSTRACT
The recent war in Iraq presents significant challenges for the surveillance and control of communicable diseases. In early April 2003, the World Health Organization (WHO) sent a team of public health experts to Kuwait and a base was established in the southern Iraqi governorate of Basrah on May 3. We present the lessons learned from the communicable disease surveillance and control program implemented in the Basrah governorate in Iraq (population of 1.9 million) in April and May 2003, and we report communicable disease surveillance data through June 2003. Following the war, communicable disease control programs were disrupted, access to safe water was reduced, and public health facilities were looted. Rapid health assessments were carried out in health centers and hospitals to identify priorities for action. A Health Sector Coordination Group was organized with local and international health partners, and an early warning surveillance system for communicable disease was set up. In the first week of May 2003, physicians in hospitals in Basrah suspected cholera cases and WHO formed a cholera control committee. As of June 29, 2003, Iraqi hospital laboratories have confirmed 94 cases of cholera from 7 of the 8 districts of the Basrah governorate. To prevent the transmission of major communicable diseases, restoring basic public health and water/sanitation services is currently a top priority in Iraq. Lack of security continues to be a barrier for effective public health surveillance and response in Iraq.

Author Affiliations: WHO, Communicable Diseases, Communicable Disease Surveillance and Response, Epidemiology Strengthening, Lyon, France (Drs Coulombier and Valenciano); Centers for Disease Control and Prevention, National Center for Environmental Health, International Emergency and Refugee Health Branch, Atlanta, Ga (Dr Lopes Cardozo); WHO, Emergency and Humanitarian Action, Geneva, Switzerland (Dr Colombo); Basrah Department of Public Health, Basrah, Iraq (Drs Alla and Samson); WHO, Communicable Diseases, Program on Communicable Diseases Complex Emergencies, Geneva, Switzerland (Dr Connolly).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Establishing Public Health Security in a Postwar Iraq: Constitutional Obstacles and Lessons for Other Federalizing States
Wilson et al.
Journal of Health Politics, Policy and Law 2009;34:381-399.
ABSTRACT